The development of clinical guidelines in China: insights from a national survey
Copyright policy )The development of clinical guidelines in China: insights from a national survey
AbstractBackgroundPrevious research suggests that the quality of clinical guidelines (CGs) in China is suboptimal. However, little is known about the methodology that CGs follow. We conducted a national survey of methods used by Chinese CG developers for CG development, adaptation, and updating.MethodsWe used a previously piloted questionnaire based on methodologies of CG development, adaptation, and updating, which was distributed during September–November 2020 to 114 organizations identified from published Chinese CGs (searched 2017–2020), recommended by Chinese CG developers, and recommended by clinical discipline experts.ResultsWe collected 48 completed questionnaires (42.1% response). Most organizations developed CGs based on scientific evidence (89.6%), existing CGs (75%), or expert experience and opinion (64.6%). Only a few organizations had a specific CG development division (6.3%), a CG monitoring plan (on clinicians 33.3%; on patients 18.8%), funding (33.3%), or a conflict-of-interest (COI) management policy (23.4%). Thirty (62.5%) organizations reported using a CG development methodology handbook, from international organizations (14/30, 46.7%), methodology or evaluation resources (3/30, 10.0%), expert experience and opinion (3/30, 10.0%), or in-house handbooks (3/30, 10.0%). One organization followed a published adaptation methodology. Thirty-eight organizations (88.4%) reported de novo CG development: 21 (55.3%) formed a CG working group, and 29 (76.3%) evaluated the quality of evidence (21 [72.4%] using a methodological tool). Nineteen organizations (52.8%) reported CG adaptation: three (31.6%) had an adaptation working group, and 12 (63.2%) evaluated the quality of source CGs (2 (16.7%) using the AGREE II instrument). Thirty-three organizations (68.8%) updated their CGs, seven (17.5%) using a formal updating process.ConclusionsOur study describes how CGs are developed in a middle-income country like China. To ensure better healthcare, there is still an important need for improvement in the development, adaptation, and updating of CG in China.
- McMaster University Canada
- Lanzhou University China (People's Republic of)
- First Affiliated Hospital of Zhengzhou University China (People's Republic of)
- McMaster University (McMaster Centre for Software Certification) Canada
- Autonomous University of Barcelona Spain
Medicina clínica, Practice guideline, China, Evidence-Based Medicine, DISCIPLINES AND OCCUPATIONS::Health Occupations::Health Occupations::Medicine::Clinical Medicine::Evidence-Based Medicine, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Epidemiologic Methods::Data Collection::Surveys and Questionnaires, DISCIPLINAS Y OCUPACIONES::profesiones sanitarias::profesiones sanitarias::medicina::medicina clínica::medicina basada en datos científicos, Research, HEALTH CARE::Health Services Administration::Patient Care Management::Delivery of Health Care, Evidence-based practice, Enquestes, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::recopilación de datos::encuestas y cuestionarios, ATENCIÓN DE SALUD::administración de los servicios de salud::gestión de la atención al paciente::prestación sanitaria, Surveys and Questionnaires, Humans, Public aspects of medicine, RA1-1270, Surveys and questionnaires, Assistència sanitària - Utilització, Delivery of Health Care
Medicina clínica, Practice guideline, China, Evidence-Based Medicine, DISCIPLINES AND OCCUPATIONS::Health Occupations::Health Occupations::Medicine::Clinical Medicine::Evidence-Based Medicine, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Epidemiologic Methods::Data Collection::Surveys and Questionnaires, DISCIPLINAS Y OCUPACIONES::profesiones sanitarias::profesiones sanitarias::medicina::medicina clínica::medicina basada en datos científicos, Research, HEALTH CARE::Health Services Administration::Patient Care Management::Delivery of Health Care, Evidence-based practice, Enquestes, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::recopilación de datos::encuestas y cuestionarios, ATENCIÓN DE SALUD::administración de los servicios de salud::gestión de la atención al paciente::prestación sanitaria, Surveys and Questionnaires, Humans, Public aspects of medicine, RA1-1270, Surveys and questionnaires, Assistència sanitària - Utilització, Delivery of Health Care
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